Healthcare Provider Details

I. General information

NPI: 1790905826
Provider Name (Legal Business Name): CARLA STEPHANIE BROWN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2007
Last Update Date: 02/09/2023
Certification Date: 02/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6501 N CHARLES STREET
BALTIMORE MD
21285-6815
US

IV. Provider business mailing address

6501 N CHARLES STREET
BALTIMORE MD
21285-6815
US

V. Phone/Fax

Practice location:
  • Phone: 410-938-3000
  • Fax: 410-938-3410
Mailing address:
  • Phone: 410-938-3000
  • Fax: 410-938-5011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberD0063742
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number86443
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: